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Parental incarceration linked to adult psychiatric outcomes in offspring

Children of incarcerated parents were more likely to develop a substance use disorder and anxiety disorder as adults, according to longitudinal research published in JAMA Network Open.

“During early and middle childhood, paternal incarceration is a risk factor for aggressive and antisocial behaviors but not for internalizing problems,” Elizabeth J. Gifford, PhD, from the Center for Child and Family Policy at Duke University, and colleagues wrote. “From adolescence onward, evidence on the outcomes of parental incarceration is more limited.”

Using data from the community-representative, prospective Great Smoky Mountains Study, Gifford and colleagued examined whether parental incarceration was tied to higher levels of mental illness diagnoses and poorer outcomes among offspring in adulthood.

Researchers interviewed children and their parents up to eight times using the Child and Adolescent Psychiatric Assessment to evaluate parental incarceration, childhood psychiatric diagnoses and other adversities from 1993 through 2000 when children were aged 9 to 16 years. Children were followed up into adulthood (ages 19, 21, 25 and 30 years) from 1999 through 2015 to examine psychiatric diagnoses and functional outcomes.

Overall, 475 participants had an incarcerated parental figure by age 16 years.

Analysis revealed that parental incarceration was linked to higher prevalence of psychiatric diagnoses in childhood, including any depressive diagnosis (adjusted OR = 2.5; 95% CI, 1.3-4.6), ADHD (aOR = 2.3; 95% CI, 1-5.5) and conduct disorder (aOR = 2.5; 95% CI, 1.4-4.3).

After Gifford and colleagues adjusting for childhood psychiatric diagnoses and adversity exposure, parental incarceration remained linked to greater risk for:

• having an illicit drug use disorder (aOR = 6.6; 95% CI, 2.6-17);
• having an adult anxiety disorder (aOR = 1.7; 95% CI, 1-3);
• having a felony charge (aOR = 3.4; 95% CI, 1.8-6.5);
• incarceration (aOR = 2.8; 95% CI, 1.4-5.4);
• not completing high school (aOR = 4.4; 95% CI, 2.2-8.8);
• early parenthood (aOR = 1.7; 95% CI, 1-3); and
• being socially isolated (aOR = 2.2; 95% CI, 1.2-4).

“Our findings are informative about the potentially high societal costs of incarcerating children’s caregivers — potentially for generations to come,” the investigators wrote. “From a public health perspective, preventing exposure to parental incarceration could improve the well-being of children and young adults, as could aiding children and families affected by the incarceration of a parental figure.” – by Savannah Demko

Disclosures: Gifford reports small honoraria for review grants from the NIH and the RobertWood Johnson Foundation outside. No other authors reported relevant financial disclosures.